AUTHOR=Sugar Dana , Pirio Richardson Sarah 

TITLE=Treating non-motor symptoms in dystonia: a systematic review

JOURNAL=Dystonia

VOLUME=Volume 4 - 2025

YEAR=2025

URL=https://www.frontierspartnerships.org/journals/dystonia/articles/10.3389/dyst.2025.14545

DOI=10.3389/dyst.2025.14545

ISSN=2813-2106

ABSTRACT=IntroductionDystonia is characterized by dysfunctional movements and postures and current treatments aim to reduce unwanted muscle activity. Dystonia also encompasses non-motor symptoms which are becoming increasingly recognized as important contributors to quality of life. Less attention has been paid to treating these non-motor symptoms. This systematic review was undertaken to describe what is known regarding non-motor symptom treatment in dystonia.MethodsA systematic review was undertaken of the published literature from 2019 to 2025. Studies on dystonia that included description of non-motor symptoms and changes after treatment were included.Results408 records were identified for review with 89 meeting inclusion and exclusion criteria for full review. 22 reports and 10 additional studies from review of references were included in the review. Treatments were stratified by type of treatment (e.g., surgical, non-invasive neurostimulation, and botulinum toxin injection) as well as by type of dystonia (e.g., generalized vs. focal vs. segmental). Response of non-motor symptoms to surgical treatment were mixed. Ablative therapy showed some improvements in non-motor symptoms but with the inherent risks of ablative procedures. Botulinum toxin consistently improved mood and pain across multiple dystonia populations.ConclusionThis review summarizes the current state of treatment effects of non-motor symptoms in dystonia. In most cases, the treatments were primarily aimed at motor symptoms but changes were sometimes seen in non-motor symptoms as well. Better detection and treatment of non-motor symptoms in dystonia are needed to wholly treat patients with dystonia.